Webinar-Attachment- Mike Rechtien


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Mike Rechtien, Therapist at Castlewood Treatment Center presents this 1 hour webinar on attachment and Eating Disorders

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  • 1975 MN Longitudinal Study - behavior is seen as a joint product of past history and current circumstances
  • 267 third trimester 1st time mothers, now their great grandchildren!
  • Feeling of SAFETY is compromised. Bowlby/Attachment is, more than anything, a strategy for SAFETY!
  • Understand perspective of child, in the moment, while neuron pathways are forming
  • But what if the parent is anxious, depressed, or dissociative? How does that affect…?
  • This is especially important to a newborn, and infants… Care and safety
  • The Crystal Ball – general population = 1. secure, 2. Ds….
  • ….how is this seen? Another way – Limbic System material crashes into the working cognitive brain.
  • English linguistic philosopher Paul Grice
  • What actually happened? If we could have been there – Strange Situation
  • If we could have been there – AAI and an intervention. But we can give the clt the AAI
  • E3 traumatic terrifying events currently controlling E2 angrily
  • Not instrumental or material love, but emotional. An unfolding, not molding.
  • Children are like > Lion Cub example……Balance of Attach system and Exploration system
  • Should be in treatment together. Att trauma – incessant = continuous, relentless, unending
  • Att trauma – neuron pathways; Family – metacognitional thinking; Primates and mammals socially, then when stressed – return to cages
  • For better or for worse
  • Webinar-Attachment- Mike Rechtien

    1. 1. L. Alan Sroufe
    2. 2. Assessments of early experience and current contexts together always predict psychopathology better than either alone.Early experience does not directly or solely cause later problems, yet has a special role through framing of subsequent experience.Foundations add to current contexts in predicting pathology and that troubled children having positive early foundations are more likely to recover than troubled children who do not. TheObversely, children with histories of anxious attachment who are functioning well in middle childhood are more likely to have problems in adolescence or adulthood than are other well- functioning children.
    3. 3. We become who we see reflected in themirrors of our parents’ eyes…?Developmental perspectiveED controversy - Temperament, genetic predisposition vs. blaming mothersMike Rechtien, MAPrimary TherapistCastlewood Treatment Center, St. Louis, MO
    4. 4. Something unusual:• Sensory integration difficulties• Emotional dysregulation• Highly sensitive/reactive• Excessive caretaking or• Overly controlling
    5. 5. What actually happened?Memory is falliblePoisonous pedagogy (A. Miller) as good parentingThe perspective of the childWe can predict attachment of unborn child with 80% accuracyCorrelation of Strange Situation behaviors with narratives of adults
    6. 6. Connection between CNSsMirror neurons1 second delayIntertwinedMentalizing/Reflective Function – Allen/FonagyContingent Communication - SeigelSafe Haven – Bowlby
    7. 7. 1. the ability to reflect on ones internal emotional experience2. make sense of it and at the same time…3. reflect on the mind of another “Mentalizing” (Fonagy, 2001, 2002)
    8. 8. 1. Secure - high coherence, evidence for what they say, succinct but complete, relevant to the topic of conversation, clear and orderly2. Dismissing – idealized, or derogatory about attachment (avoidant)3. Preoccupied – angrily, passively or fearfully (ambivalent)4. Unresolved in relation to loss or abuse (disorganized)
    9. 9. Her interest was in the coherence of the narrative.Rather than focusing on the individual’s story,she looked at the structure of the story – what theperson allows themselves to know, feel, andremember in telling the story. Breaks in the story,disruptions, inconsistencies, contradictions,lapses, irrelevancies, and shifts are important,relevant and diagnostic, as they are linguistic efforts to managethat which is not regulated in experience ormemory.
    10. 10. Disorganized (U/d) adult subjects exhibitedperformance issues on frontal lobe tasks,especially working memory tasks.Suggests that too much stress is placed onworking memory when a speaker attempts tosimultaneously recall and discuss a frighteningexperience. Anne Rifkin (2005)U/d subjects are scored so due to lapses in themonitoring of discourse or reason.
    11. 11. 1. Quality – truthfulness (internal consistency)2. Quantity – succinct but complete3. Relation – relevant to the discourse4. Manner – clear and orderly
    12. 12. Maybe ED is more about attachment than food.Clients relationship with food is a lot like theirrelationships with people.In times of stress it substitutes for people.Social Anxiety treatment doesn’t take.Behavioral therapies don’t work in the long run.What if the client’s relationship with food is a re-enactment of early attachment disruptions with atransitional object that can be controlled and isalways accessible?
    13. 13. The parent’s coherence of narrative on the AAIShows capacity of the adult to make sense of the mind of self and capacity to detect child’s behavior and see implicated mind (behind the behavior) and respond in a timely and effective manner
    14. 14. Attachment relationships are defined by emotional vulnerabilityChild’s experience of parental behaviors: Rejection – child goes to parent with tender emotions and is turned away Neglect – parent physically available but emotionally unavailable Involving/Role Reversal – child’s attachment is used for the parent’s gain Loving – an active dedication to the development of the child as an individual
    15. 15. U/d – Disorganized in attachment, unresolvedconcerning loss or traumaE – Preoccupied in attachmentDs – Dismissive of attachmentCC – Cannot Classify - Uses opposing (E and Ds)attachment strategiesF- Secure (almost nonexistent)
    16. 16. AAIs of complex trauma clients look a lot likeAAIs of our “perfect family” clients.Attachment trauma – small “t” trauma?Disruption of attunement that contributes tosensory integration issuesED as a disorder of intimacy vs. a disorder ofeatingStudy patterns of attachment and designtreatments accordingly
    17. 17.  Values attachment and regards attachment experiences as influential Acknowledge need for others Freely explore thoughts and feelings Remember childhood events clearly At ease with their own imperfections Don’t idealize family or have involving anger And produce secure infants!! J. Allen, 2001
    18. 18.  Infant not capable of emotion regulation (i.e. need assistance from the caregiver) Early attachment development overlaps with SIGNIFICANT neurological development Research has shown a high correlation between caregiver’s attachment strategy and infant attachment strategy (80%) Attachment is central to the capacity to regulate emotions
    19. 19.  When a caregiver reads the verbal and non- verbal cues of the child and reflects them back, the child sees him or herself through their interaction with the attachment figure. It is through this attunement and contingent communication process that the seeds of the developing self are planted and realized. Fonagy (2001, 2002)
    20. 20.  “During infancy and childhood, working models are thought to be somewhat flexible and responsive to changes in the environment. However, as the child grows older, working models become established and the child is more likely to assimilate new experiences into the existing model.” Leveridge, Stoltenberg, and Beeseley (2005)
    21. 21.  Thoroughly resolve Loss and Trauma - state dependent memory work (IFS, EMDR, Hypnotherapy), cognitive processing, narrative work, expressive work Contextualizing attachment environment and its importance – “T squared” Neglect, Rejection, Involving Behavior, Role Reversal, witnessing terrifying events Reduce Idealization to deal with self blame
    22. 22.  Reduce family enmeshment and expose family secrets, legacy burdens Expose preoccupied anger seen through projection and criticism Establishing a coherent narrative regarding one’s life Self agency – action as opposed to reaction
    23. 23. L. Alan Sroufe
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